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Diet and MS: Part 3

So, aside from feeling confused, where does
this leave us? What is a patient with MS to do with regards to diet? First of
all, let me say that I think the vast majority of patients with MS have
relatively healthy diets to begin with. With a few exceptions, most of my
patients are young, fit people who exercise often and don’t appear to get the
majority of their meals from fast food restaurants.

When a patient asks me what
they should do about diet, I tell them that my suggestions are no different
from anyone who does not have MS. They should not eat too much, they should eat
plenty of fruits and vegetables, and they should try to lay off the junk food
(though I know how hard this can be!). Even if this does not impact their MS,
it will help their waistline as well their cardiovascular fitness. Generally, I
tell patients that they should enjoy food like anyone else. It is, after all,
one of life’s great pleasures.

I give similar advice when it comes to
supplements. Many patients I see take numerous supplements and vitamins daily. Based
on the available evidence, I cannot advise them that any of these supplements
offer any particular benefit, though I am optimistic that further studies will
support a role for vitamin D.

Additionally, I am concerned that taking large doses of certain
supplements and vitamins may have unforeseen adverse side effects. Many patients feel safe because they feel
they are taking something “natural.” Most likely, such supplements will be
excreted harmlessly in the urine. However, I think it is a mistake to say that
just because something is “natural” it must be harmless and without side
effects. Few people would eat random
berries and mushrooms they found in a forest simply because these were
“natural.” Additionally, almost anything—if
taken in a high enough dose—can have serious adverse health effects. There is a saying in medicine that “the dose
determines the poison” and there have been cases of people dying from drinking
too much water!

Another consequence of patients taking large
quantities of vitamins and supplements is that some of them can be quite
expensive. Few of my patients have money to burn, and I suspect that their
money can often be put to better use. So,
other than suggesting that patients take vitamin D, I recommend that patients
save their money until further evidence emerges that any of the supplements are
helpful.

Clearly, more research is
needed to determine the role of diet and nutrition in MS.

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